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General NPI Number Information
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NPI Number | 1497840706
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Entity Type | Individual
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Provider Name | KRYSTYNA ZIETKIEWICZ DDS
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 88 RYDERS LANE
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City | STRATFORD
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State | CT
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Zip | 06614
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Country | US
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Telephone | 203-378-1566
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Fax |
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Provider Business Mailing Address
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Address Line | 125 NORTH ST
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City | EASTON
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State | CT
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Zip | 06612
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Country | US
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Telephone | 203-220-9216
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 009074
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License Number State | CT
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